USAID in Anti-AIDS Drive. 13/1/11
USAID hoped to extend a comprehensive HIV/AIDS workplace programme
By Simon Musasizi
13 January 2011
USAID/HIPS first partnered with Nile Breweries in 2005, hoping to extend a comprehensive HIV/AIDS workplace programme to 400 permanent employees, 9,240 indirect employees and surrounding communities of Njeru and Mbiko towns Until recently, Mary Abiari couldn't figure out why her three-year-old son was always down with malaria.
This mother of six and resident of Orukurukun village, Usuk parish, Katakwi district, once contemplated taking an HIV test but because the testing facilities are 22km away at Katakwi health centre IV, she abandoned the idea.
It was not until May last year that Abiari's family were tested for HIV/AIDS. The USAID/HIPS (Health Initiatives for Private Sector) had launched their home based counselling and testing programme for Nile Breweries' small-scale farmers.
It turned out that Abiari and her husband were a discordant couple that passed the virus to their three-year-old son.
However, even after the discovery, the couple has refused to use condoms as a preventive measure. "We are Catholics and it is against our religious principles to use condoms," Abiari says, adding, "God created us to procreate."
Home based counselling and testing in Usuk parish started in March last year following Nile Breweries' desire to expand the programme to its small-scale farmers in the rural areas.
They designated Usuk health centre III to implement the programme, training 14 peer educators who, in pairs per village, registered over 4,500 people interested in HIV/AIDS counselling and testing.
According to Daniel Kasansula, programme officer at HIPS, 2,632 people have so far been counselled and tested in their homes. Of these, 108 are HIV positive, indicating a 4% prevalence rate. Among the 156 monogamous couples tested, 15 are HIV positive, seven of whom are discordant.
"That is a very difficult situation that needs well trained counsellors to help the couple accept and understand that one of them who doesn't have HIV/AIDS does not contract it," Pauline Latham, a British MP visiting the programme said.
"There has to be a lot of education about condoms as a barrier to stop the transmission from one of the discordant couple to the other, but it is otherwise very difficult for the couple to resolve it between themselves," she added.
Yet, chances are minimal that something can be done since, as a Catholic founded entity, Usuk health centre III does not allow the use of condoms.
"This highly affects the discordant couples," says Robert Adakun, a peer educator.
"We have to find other places where to keep condoms for them," he adds.
The Roman Catholic Church has for years discouraged the use of condoms in the fight against AIDS, with the Pope speaking strongly against condoms, a policy that has divided some clergy working with HIV/AIDS patients.
According to Caroline Akello, the health centre deputy in-charge, all people who test positive are referred to Katakwi Health Center IV for treatment.
But because of the long distance between Usuk and Katakwi, all the 108 patients survive on septrin (prophylaxis). The anti-biotic is meant to shield them against opportunistic diseases.
The current government policy does not allow accreditation of health facilities below level IV to provide antiretroviral therapy (ART) services.
"For a health centre to qualify to offer ARVs, it should be able to monitor the CD4 count for its patients; and in the whole of Katakwi district, it's only Katakwi health centre IV authorised to take blood samples to Mbale Joint Clinical Research Centre," says Akello.
Yet the centre, which collects the samples every Thursday, is permitted to submit only 50 blood samples a week and the results are released twice a month.
"Not all our clients have access to CD4 count because Mbale cannot take more than 50 samples," says Dorothy Asio, the senior nursing officer at the centre.
Deborah Apeitun, 30, a resident of Akwooro village, Usuk parish, has been frequenting the health centre since July 2010 but until today, she has not had her CD4 counted. This mother of four depends on Usuk health centre III for antibiotics.
It is against this background that USAID initiated the HIPS project in 2007 to work with the business community seeking cost-effective ways to ensure access to vital health services for company employees, their dependants and surrounding community.
USAID/HIPS first partnered with Nile Breweries in 2005, hoping to extend a comprehensive HIV/AIDS workplace programme to 400 permanent employees, 9,240 indirect employees and surrounding communities of Njeru and Mbiko towns. The partnership involved using Nile Breweries' resources and staff to educate the communities about HIV/AIDS. Through the partnership, the health programme has scaled up to benefit Nile Breweries' supply chain including the small-scale sorghum growers, hospitality workers and truck drivers in the different parts of the country.
But Latham notes that unless government puts drugs into the clinics, such partnerships will not achieve a lot.
"People will know they have got HIV/AIDS but there will be no drugs for them and that is the worst thing," she says.